Anuraksha Specialised Orthopaedic Clinic

Hi,

I am Dr. Rakesh Kumar, Orthopedist. Me apko aaj knee and usse related problem ke bare me btana chahunga. Ye 3 bones ko mila kr banta hai femur, tibia, patella. Inke fracture open surgery se hi thik kia jate hain. Lekin ligament injury and ACL (anterior cruciate ligament) injury, posterior cruciate ligament or meniscus injury durbin se thik ki jati hai. Hum knee ko repair krte hain. Sabse jyada injury mediale meniscus me hoti hai or lateral meniscus me kam injury hoti hai. Agar in dono me se kuch bhi damage hota hai to vo bone ko rub krega. Is ke treatment me agar pura damage hai to hum ise pura nikal dete hain.

Aaj kal hmari koshish hoti hai ki isko hum repair kr den. Repair krne se hmara joint filler ka kam krta hai. Isko krne se joint contact area kafi badh jata hai. Bone ka stress ek dusre pe bhut kam hota hai. Bone kharab hone se arthritis ke chances bhi badh jate hain. Inko repair krne ke lia hum multiple ligaments lete hain. Sab tendons ko leke multi ligament injury ko repair kia jata hai. ACL repair krne se anterior rukta hai knee ka and PCL repair krne se posterior rukta hai knee ka. Hum implantation technique use krte hain. Ab ek new procedure me hum cartilage ko lete hain. Usko culture ke lia bhejate hain and vapas re-implant krte hain. Agr uske baad bhi knee khrab hota hai to replacement ki jrurat pdti hai. Replacement kafi successful procedure hai.

Thank You!

Namaskar!

Main Dr. Rakesh Kumar. Aaj me apko shoulder dislocation ke bare me btaunga. Isme ek bone dusri bone ke socket se nikal jati hai. Ise dislocation kehte hain. Agar bone thik se nhi niklti to use subluxation kehte hain. Shoulder dislocation 3 types ka hota hai. Anterior dislocation mtlb kandha nikal gya hai or samne ki traf aa gya hai. Ek chot lagne ki vjha se bhi ho skta hai or bina chot ke bhi. Ek hai posterior dislocation jisme kandha piche ki taraf nikal jata hai. But ye situation bhut kam hoti hai. 97% anterior dislocation hai or 3% posterior dislocation hai. Aisi situation bhi hoti hai ki hath upar ki traf uth jata hai. Aisi problem ko immediate attaention ki jrurat hoti hai. Otherwise isme bone damage ho jata hai, muscles fatne ke chances hote hain. Iske lia radiography or x-ray kia jata hai. Isme dekha jata hai ki koi fracture to nhi hai. Agar fracture hai to re-dislocation ke chances bhut hain.

Jitni bar dislocation hoga utni bar haddi ghisegi. Teeno ka reduction bhut jruri hai fir vo bone ke sath ho ya fracture ke sath. Isme kbhi anesthesia dia jata hai or kbhi nhi. Aaj kal ki techniques se bina surgery ke bhi is problem ko thik kia ja skta hai. Reduction hone ke baad bhi isko check krte rehna jruri hai. Otherwise joint re-dislocate ho jata hai. Kbhi kbhi patient ka hand dead bhi ho jata hai jisme uska hath bilkul bhi kam nhi krta. Ise dead arm syndrome kehte hain. Ek situation hota hai jisme kandha bahar ko aane lgta hai or vo kam nhi krta. In sab chizon ko proper address kr k hum thik kar skte hain. Isme MRI kraya jata hai. Agar fracture hai to CT-scan bhi krate hain. Lekin starting stage me hi arthroscopy se ye problem thik ho jati hai. Isme 3 keyholes dia jate hain. Lekin agar patient surgery nhi krata hai to patient ki bones baar baar ghisti hai or fir surgery bhi successful nhi hoti hai.

And aise case me major surgery krni pdti hai. Major surgery me pure kandhe ko kholte hain. Jo bone ghis jati hai, usme dusri bone lga di jati hai. Jis se dislocation ke chances kam ho jate hain. Llekin still movement restricted ho jata hai. Lekin arthroscopy ke baad ye chances kam ho jate hain. Is surgery se root cause ka pta chal jata hai or sari chizen aram se manage ho jati hai. Agar patient ko fir bhi koi pain feel ho rha hai to immediate attention ki jrurat hai. Agar condition worst ho jaye to shoulder ko replace krna pdta hai. Rotator ko bhi repair krne ki jrurat pdti hai. Lekin aisi condition me result poor aane ke chances hote hain. Kbhi kbhi usme koi bhi option useful nhi hota hai. Islia kbhi bhi apko shoulder ka koi bhi problem ho to doctor ko jrur dikhayein.

Thank You!

Know more about the symptoms and types for frozen shoulder

Good morning everybody, I am doctor Rakesh Kumar, I am senior consultant in orthopedics in Apollo hospital, Jivan mala and MGS hospital. Today I am going to give health tips on frozen shoulder. Frozen shoulder is named as Adhesive Capsulitis. Adhesive Capsulitis is a condition in which contracted thickened joint capsules that seem to be drawn tightly around a humeral head in the absence of synovial fluid and chronic inflammatory changes within the subsynovial layer of the capsule occurs. The underlying pathological change in adhesive capsulitis are sinonasal inflammation, with subsequent reactive capsular fibrosis, cytokines and metaloprotanysis have been implicated in the process but the initial triggering event in the cascades is unknown. Incidence is 2%, but several conditions are specified with increased incidence, includes gender—i.e more common in females, more common in older ages—between 40 to 70 years, 5 times more common in diabetes mellitus, cervical disc diseases, prolonged immobilization, hyperthyroidism, stroke, or myocardial infections, the presence of autoimmune disease and trauma.

Individuals between ages 40 to 70 are more commonly affected, approximately 70% patients are females. 20% to 30% of affected individuals develop adhesive capsulitis in the opposite shoulder. Frozen shoulder in patients who report no inciting event and with no abnormality are designated as primary whereas in patients with precipitant traumatic injuries are designated as secondary. We have noted that internal rotation frequently is lost in sleep followed by loss of fluctuation and external rotation, most often our patients can internally rotate only upto the sacrum, have 50% loss of external rotation and have less than 90 degree of abduction.

We include these patients in the diagnosis of frozen shoulder.

Primary frozen shoulder have three phases-

Phase 1 is a phase of pain, patients usually have a gradual onset of diffused shoulder pain which is progressive over weeks to months, the pain usually is worse at night, and is exacerbated by lying on the affected side as the patient uses the arm less leading to stiffness.

Phase 2 is stiffness, Patient seeks pain relief by restricting movements this heralds the beginning of stiffness phase which usually lasts for 4 to 12 months. Patients describe difficulty in activity of daily living, men have trouble getting to their wallets in their back pockets while females have trouble with fastening their brassieres.

Phase 3 is pain thawing phase, this phase lasts for weeks or months. And as motion increases pain diminishes without treatment other than benign neglect motion return is gradual in most but may never objectively return to normal. Although most patients subjectively feels near normal, they make adjustments in ways of performing activities of daily livings.

Treatments- Frozen shoulder has been considered as self limiting condition lasting 12 to 18 months without long term sick leave.  Approximately 10% of patients have long term problems. The best treatment of frozen shoulder is prevention. But early intervention is paramount. A good understanding of the pathological process by the patient and the physician also is important.

If you need further clarification and have any question and need any treatment you can contact me through Lybrate.